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1. Burden of Hypertensive Crisis in Patients With End-Stage Kidney Disease on Maintenance Dialysis: Insights From United States Renal Data System Database

Author

Suveenkrishna Pothuru, Wan-Chi Chan, Harsh Mehta, Mohinder R. Vindhyal, Sagar Ranka, Jinxiang Hu, Sri G Yarlagadda, Mark A. Wiley, Eric Hockstad, Peter N Tadros, and Kamal Gupta

Subjects
Internal Medicine
Abstract

Background: There is paucity of information on the incidence, clinical characteristics, admission trends, and outcomes of hypertensive crisis (HTN-C) in patients with end-stage kidney disease (ESKD) who are on maintenance dialysis. Methods: We conducted a retrospective observational study of HTN-C admissions in patients with end-stage kidney disease using the United States Renal Data System. We identified patients with end-stage kidney disease aged ≥18 years on dialysis and were hospitalized for HTN-C from January 2006 to August 2015. Results: A total of 54 483 patients with end-stage kidney disease were hospitalized for HTN-C during the study period. After study exclusions, 37 214 patients were included in the analysis. A majority of patients were Black, there were more women than men and the South region of the country accounted for a great majority of patients. During the study period, hospitalization rates increased from 1060 per 100 000 beneficiary years to 1821 ( P trend P trend Conclusions: Hospitalizations for HTN-C have increased consistently during the decade studied. Although temporal trends showed improving mortality and readmission rates, the absolute rates were still high with 1 in 3 patients readmitted within 30 days and 1 in 5 patients dying within 1 year of index hospitalization.

Published
2023
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6. Abstract 10258: Do Statins Impact Long-term Mortality Peripheral Artery Disease Patients Who Have End Stage Renal Disease?

Author

Sagar Ranka, Wan Chi Chan, Peter Tadros, Mark A Wiley, Eric Hockstad, and Kamal gupta

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Introduction: Statins have shown mortality benefit in peripheral artery disease (PAD), their impact in end-stage renal disease (ESRD) patients with PAD is not well studied. Hypothesis: Does statin utilization have any impact on mortality in ESRD patients with PAD? Methods: We included ESRD Medicare beneficiaries from the United states Renal Database (Jan 1 st 2006 to May 31 st 2017) with PAD within 6 months of incident dialysis. Medicare part D claims were used to determine STU during the follow-up period. Fractional polynomial regression across varying % of STU was generated to predict 2-year mortality. Results: Out of 45,424 ESRD patients with PAD, 62.3% received no statins while the rest had at least some duration of STU. ST was bimodally distributed, with median utilization of 0% (IQR= 0-90%). Mortality was 41.7% over a median follow-up of 472 days. Univariate association of STU on mortality yielded odds ratio (OR) of 0.99 (95% CI = 0.992-0.993; p Conclusions: Statin utilization in ESRD patients is associated with only borderline statistically significant reduction in mortality (≈0.1%) of unclear clinical implications

Published
2021
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7. Abstract 16460: Differential Effect of the Emory Risk Score on Early versus Late Pacemaker Implantation in TAVR Patients

Author

Alex Courtney, Madhu Reddy, Muelhebach Gregory, Tarun Dalia, George L. Zorn, Raghuveer Dendi, Eric Hockstad, Peter Tadros, Farhad Sami, Rigoberto Ramirez, Rhea Pimentel, Sagar Ranka, Nachiket Apte, Amit Shreshta, Seth H. Sheldon, Martin Emert, and Mark Wiley

Subjects
medicine.medical_specialty, Framingham Risk Score, business.industry, Physiology (medical), Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, Pacemaker implantation
Abstract

Introduction: The Emory risk score has been developed to predict new pacemaker implantation in patients undergoing TAVR procedures. There is limited data on assessing risk of early versus late pacemaker implantation in these patients. Hypothesis: The Emory risk score is similar for patients with both early and late pacemaker implantation in TAVR patients. Methods: A single center observational study was performed at our tertiary care center. All patients who underwent pacemaker implantation after TAVR procedures were included. Patients were categorized as early or late if they had pacemaker implantation within the same admission versus implantation post discharge. Standard statistical tests were used for analysis with two-sided p value Results: A total of 97 patients were studied between January 2017 to April 2020. The mean age was 77.5 ± 7 years and females were 41.2%. At baseline patients with early implantation of pacemakers (n=66) had a higher proportion of underlying RBBB (45.2% vs 23.3%, p=0.43), higher valve size as well as a higher incidence of valve oversizing > 146% (43.9 % vs 19.4 %, p =0.23)when compared to patients with late pacemakers(n=31). There was no difference between patient characteristics, baseline comorbidities, pre procedural ECG parameters as well as use of beta blocking agents. Late pacemaker implantations were associated with a overall lower Emory Risk score (1.06±1.41 vs 1.70±1.35, p =0.037). Conclusions: The Emory Risk score is significantly different for early and late pacemaker implantation. Further studies are needed evaluate risk of late pacemaker implantation.

Published
2020
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8. Optical Coherence Tomography Utility in Management of Coronary Artery Injury Due to Blunt Chest Trauma

Author

Enrique Campos, Prince Sethi, Kamal Gupta, RN Mark Reichuber, Jeffrey B. Kramer, and Eric Hockstad

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Thoracic Injuries, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Coronary Angiography, Wounds, Nonpenetrating, Coronary Vessels, Blunt, Percutaneous Coronary Intervention, Treatment Outcome, Optical coherence tomography, Artery injury, medicine, Humans, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, Optical Coherence
Published
2020

11. Cangrelor With and Without Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Percutaneous Coronary Intervention

Author

Muthiah Vaduganathan, Robert A. Harrington, Gregg W. Stone, Efthymios N. Deliargyris, Ph. Gabriel Steg, C. Michael Gibson, Christian W. Hamm, Matthew J. Price, Alberto Menozzi, Jayne Prats, Steven Elkin, Kenneth W. Mahaffey, Harvey D. White, Deepak L. Bhatt, Fernando Cura, Miguel Ballarino, Anibal Agustín Damonte, Diego Grinfeld, Carlos Alejandro Álvarez, Alberto Fernandez, Ahmad Farshid, Brendan Gunalingam, Craig Jeurgens, Harry Lowe, Hisham Hallani, Greg Nelson, Gishel New, Ronald Dick, Jeffrey Lefkovits, Stephen Duffy, Nick Bett, Raibhan Yadav, Paul Garrahy, Ron Lehman, Philip Aylward, John Horowitz, Matthew Worthley, David Cross, Jaime Rankin, Peter Thompson, Phil Roberts-Thomson, Rohan Jayasinghe, Con Aroney, Kurt Huber, Franz Leisch, Johann Altenberger, Georg Gaul, Thomas Neunteufl, Franz Weidinger, Herwig Schuchlenz, Heinrich Weber, Werner Benzer, Paulo Rossi, Breno Almeida, Antonio Godinho, Fabio Vilas-Boas, Luciano Vacanti, Renato Serpa, José Antonio Jatene, Gilmar Reis, Jamil Saad, Marcos Marino, Roberto Botelho, Constantino Costantini, Ricardo Wang, Dalton Precoma, Miguel Rati, Luis Bodanese, Euler Manenti, João Paulo Zouvi, Rogerio Tumelero, Arthur Herdy, Eulogio Martinez Filho, Antônio Carvalho, Roberto Franken, Lawrence Title, Charles Lazzam, Francois Reeves, Tamaz Shaburishvili, Gulnara Chapidze, Merab Mamatsashvili, Irakli Khintibidze, Hubertus Heuer, Hans-Georg Olbrich, Sabine Genth-Zotz, Sven Moebius-Winkler, Michael Buerke, Stefan Hoffmann, Peter Radke, Helge Moellmann, Hugo Katus, Hans-Friedrich Voehringer, Christian Hengstenberg, Volker Klauss, Johannes Brachmann, Aftab Khan, Sampath Kumar, Padinhare Mohanan, Praveen Chandra, Maddury Rao, S.S. Ramesh, Keyur Parikh, Arun Srinivas, Nakul Sinha, V.S. Prakash, Shirish Hiremath, Anil Mishra, Sanjeeb Roy, Kamal Sethi, Ashwani Mehta, Tejas Patel, Suman Bhandari, Milind Gadkari, Stefano De Servi, Giuseppe Musumeci, Bernardo Cortese, Giancarlo Marenzi, Raffaele De Caterina, Ralph Stewart, Gerard Devlin, Scott Harding, John Elliott, Gerard Wilkins, Douglas Scott, Slawomir Dobrzycki, Waldemar Dorniak, Dariusz Dudek, Zbigniew Gasior, Jaroslaw Hiczkiewicz, Zdzislawa Kornacewicz-Jach, Leszek Kubik, Krzysztof Kuc, Jerzy Kuzniar, Walentyna Mazurek, Jakub Ostrowski, Michal Tendera, Andrzej Wisniewski, Elzbieta Zinka, Krzysztof Zmudka, Jana Pawła, Maciej Kosmider, null Seweryna, Andres Iñiguez, Rafael Melgares, Francisco Goicolea, Jose Hernandez, Javier Zueco, Igor Kraiz, Mykola Vatutin, Anatoliy Polyakov, Yury Sokolov, Kenneth House, Charles Campbell, Timothy Trageser, Kenneth Baran, Neal Kleiman, Roberto Medina, Roger Hill, M. Zubair Jafar, David Drenning, Herbert Ladley, Ahed Nahhas, Alan Niederman, Amit Goyal, William Abernethy, Naseem Jaffrani, Richard Zelman, Brian Negus, Jose Marquez, Ehtisham Mahmud, William French, John Paulowski, Charles Pollack, Mark Mines, Robert Federici, Marc Schweiger, Kalim Habet, Ofsman Quintana, Thomas Nygaard, Steve Orlow, Douglas Spriggs, Ivan Chavez, Mark Warner, Richard Paulus, David Cochran, Cary Hirsch, Ajay Virmani, Peter Soukas, Nalin Srivastava, L. Norman Ferrier, Annapoorna Kini, Mark Greenberg, Howard Herrmann, Valerian Fernandes, Barry Bertolet, Ron Waksman, Joseph Henderson, Harinder Gogia, Maged Amine, Kourosh Mastali, Thomas Stuckey, Peter Hui, Luigi Pacifico, Todd Caulfield, Wilson Ginete, William Ballard, Robert Iwaoka, Joseph Stella, Vijay Misra, Costa Andreou, Michele Voeltz, Wayne Batchelor, Cezar Staniloae, Sanford Gips, Jeffrey Kramer, Paul Mahoney, John Wang, Prospero Gogo, David Rizik, Rex Winters, Garry MacKenzie, Stephen Jenkins, Paul Teirstein, Pierre Leimgruber, J. Christopher Scott, Seth Krauss, Steven Rohrbeck, Robert Martin, Gustavo Grieco, Louis Cannon, Don Westerhausen, F. David Fortuin, Steven Schulman, Joel Cohn, Brent McLaurin, Jorge Saucedo, Robert Wozniak, Jack Hall, Kevin Marzo, Merrill Krolick, Lawrence Gimple, Eric Hockstad, Arsenio Rodriguez, John Kao, Adhir Shroff, Michael Attubato, Ramon Quesada, Ernesto Rivera, Dean Kereiakes, Russell Raymond, Thomas Amidon, David Lee, Spencer King, John Douglas, Abnash Jain, J. Patrick Kleaveland, Mitchell Driesman, Krishna Kumar, Glen Kowalchuk, Behzad Taghizadeh, Lawrence Barr, Keith Benzuly, Tarek Helmy, Duane Pinto, Joseph Aragon, Reginald Low, Phillip Horwitz, Thomas LeGalley, Dominick Angiolillo, Rajesh Sachdeva, Kenneth Kent, Luis Gruberg, Richard Bach, Thomas Pow, Charles O'Shaughnessy, Shing Wong, Saeed R. Shaikh, Arthur Reitman, Mark Lawrence, Alejandro Garcia Escudero, Carlos Poy, Miguel Miceli, Antonio Pocovi, Hugo Londero, Jorge Baccaro, Leonid Polonetsky, Aliaksey Karotkin, Leanid Shubau, Eduardo Maffini, Bruno Machado, José Airton, Valter Lima, Jose Jatene, Marco Perin, Paulo Caramori, Iran Castro, Ivan Manukov, Mladen Grigorov, Plamen Milkov, Julia Jorgova, Svetoslav Georgiev, Nizar Rifai, Alexander Doganov, Ivo Petrov, William Hui, Jean-Francois Tanguay, Marek Richter, Frantisek Tousek, Zdenek Klimsa, Michal Padour, Jan Mrozek, Marian Branny, Zdenek Coufal, Stanislav Simek, Vladimir Rozsival, Leos Pleva, Josef Stasek, Petr Kala, Ladislav Groch, Viktor Kocka, Rajesh Jain, Darshan Banker, Lanka Krishna, Hasit Joshi, Jaspal Arneja, Virgilijus Grinius, Sigute Norkiene, Birute Petrauskiene, Rolf Michels, Melvin Tjon, Hans de Swart, Robbert de Winter, Harvey White, Malcolm Abernethey, Alexander Osiev, Kirill Linev, Svetlana Kalinina, Svetlana Baum, Elena Kosmachova, Zaur Shogenov, Valentin Markov, Svetlana Boldueva, Olga Barbarash, Victor Kostenko, Elena Vasilieva, Aleksey Gruzdev, Victor Lusov, Pavel Dovgalevsky, Oleg Azarin, Sergey Chernov, Olga Smolenskaya, Alexey Duda, Viliam Fridrich, Marian Hranai, Martin Studenčan, Peter Kurray, John Bennett, Pieter Blomerus, Laurence Disler, Johannes Engelbrecht, Eric Klug, Robert Routier, Tjaart Venter, Nico Van Der Merwe, Anthony Becker, Kwang-Soo Cha, Seung-Hwan Lee, Sang-Jin Han, Tae Jin Youn, Seung-Ho Hur, Hong Seog Seo, Hun-Sik Park, Chong-Yun Rhim, Wook-Bum Pyun, Hyunmin Choe, Myung-Ho Jeong, Jong-Seon Park, Eak-Kyun Shin, Felipe Hernández, Jaume Figueras, Rosana Hernández, José Ramón López-Minguez, José Ramón González Juanatey, Ramón López Palop, Guillermo Galeote, Noppadol Chamnarnphol, Wacin Buddhari, Nakarin Sansanayudh, Srun Kuanprasert, William Penny, Charles Lui, Garfield Grimmett, Venkatraman Srinivasan, Kevin Ariani, Waqor Khan, James Blankenship, Steven Eisenberg, Jerry Greenberg, Jeffrey Breall, Harish Chandna, Paul Tolerico, Georges Nseir, Adam Greenbaum, Pierre Istfan, Joel Sklar, Robert Smith, Nicholaos Xenopoulos, Mahesh Mulumudi, James Hoback, Gregory Eaton, John Griffin, Ramin Ebrahimi, Robert Lundstrom, Dogan Temizer, Kenneth Tam, Jose Suarez, Amish Raval, Jay Kaufman, Emmanouil Brilakis, Michael Stillabower, Kathleen Quealy, Boris Nunez, Bruce Samuels, Agustin Argenal, Vankeepuram Srinivas, Andrew Rosenthal, Pradyumna Tummala, Paul Myers, Nelson LaMarche, Michael Chan, Daniel Simon, Richard Kettelkamp, Gary Schaer, Edward Kosinski, Maurice Buchbinder, Mukesh Sharma, Mark Goodwin, J. Tift Mann, David Holmes, Sunil Rao, Michael Azrin, Roger Gammon, Kreton Mavromatis, Abdel Ahmed, Marcel Zughaib, R. Jeffrey Westcott, Ash Jain, Georg Delle-Karth, Jamil Abdalla Saad, Alexandre Abizaid, Carlos Augusto Formiga Areas, Expedito E. Ribeiro, Fabio Rossi Dos Santos, Rogerio Tadeu Tumelero, Roberto Vieira Botelho, Borislav Atzev, Boicho Boichev, Georgi Grigorov, Nikolay Penkov, Boris Zehirov, Pavel Cervinka, Petr Hajek, David Horak, Petr Kmonicek, Jan Sitar, Nodar Emukhvari, George Khabeishvili, Steffen Behrens, Harald Darius, Martin Dissmann, Stephan Fichtlscherer, Wolfgang Franz, Tobias Geisler, Britta Goldmann, Andreas Mugge, Tudor Poerner, Gert Richardt, Christoph Stellbrink, Nikos Werner, Ezio Bramucci, Gennaro Galasso, Andrea Picchi, Patrizia Presbitero, Alexander Sasse, Szyszka Andrzej, Witold Dubaniewicz, Jaroslaw Kasprzak, Andrzej Kleinrok, Andrzej Rynkiewicz, Cezary Sosnowski, Radoslaw Targonski, Jaroslaw Trebacz, Adam Witkowski, Yakov Dovgalevsky, Ivan Gordeev, Prokhor Pavlov, Sergey Shalaev, Irina Sukmanova, Alexey Yakovlev, Sarana Boonbaichaiyapruck, Pinij Kaewsuwanna, Dilok Piyayotai, Imran Arif, Joseph Cinderella, Brent Davis, Chandanreddy Devireddy, Mark Dorogy, Norman Ferrier, Daniel Fisher, Robert Foster, John Galla, Raghava Gollapudi, James Hermiller, Richard Heuser, Zubair Jafar, Carey Kimmelstiel, Scott Kinlay, James Leggett, Dustin Letts, Michael Lipsitt, Joaquin Martinez-Arraras, Marc Mayhew, Paul McWhirter, Ayoub Mirza, William O'Riordan, John Petersen, Hector Picon, Mark Picone, Matthew Price, Virender Sethi, Craig Siegel, Daniel Steinberg, Jeffrey Tauth, Mladen Vidovich, Jonathan Waltman, and Michael Wilensky

Subjects
Male, medicine.medical_specialty, Ticlopidine, medicine.medical_treatment, Myocardial Ischemia, Hemorrhage, Platelet Glycoprotein GPIIb-IIIa Complex, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Cangrelor, P2Y12, Double-Blind Method, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Angioplasty, Balloon, Coronary, Infusions, Intravenous, Aged, Aspirin, business.industry, Percutaneous coronary intervention, Middle Aged, Clopidogrel, Adenosine Monophosphate, Surgery, Treatment Outcome, chemistry, Glycoprotein IIb/IIIa inhibitors, Conventional PCI, Eptifibatide, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Background Cangrelor, an intravenous, reversible P2Y12 antagonist, is approved for use in patients undergoing percutaneous coronary intervention (PCI). Objectives This study sought to evaluate the efficacy and safety of cangrelor compared with clopidogrel in subgroups that did and did not receive glycoprotein IIb/IIIa inhibitors (GPIs). Methods This pooled, patient-level analysis of the 3 CHAMPION (Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials analyzed all randomized patients who underwent PCI and received the study drug (n = 24,902). Only bailout/rescue GPI use was permitted, except in CHAMPION PCI, in which routine or bailout/rescue GPI use was at the site investigator’s discretion. The primary efficacy endpoint was the composite of all-cause mortality, myocardial infarction, ischemia-driven revascularization, or stent thrombosis at 48 h after randomization. Results Overall, 3,173 patients (12.7%) received a GPI, most commonly eptifibatide (69.4%). Despite variation in indications for GPIs, baseline characteristics were well balanced between the cangrelor and clopidogrel arms in subsets receiving and not receiving GPIs. Rates of the primary composite endpoint were lower with cangrelor compared with clopidogrel in patients who did (4.9% vs. 6.5%; odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.55 to 1.01) or did not receive a GPI (3.6% vs. 4.4%; OR: 0.82; 95% CI: 0.72 to 0.94; Pint = 0.55). Cangrelor did not increase the primary safety endpoint, GUSTO-defined severe/life-threatening bleeding, in patients who did (0.4% vs. 0.5%; OR: 0.71; 95% CI: 0.25 to 1.99) or did not receive GPIs (0.2% vs. 0.1%; OR: 1.56; 95% CI: 0.80 to 3.04; Pint = 0.21). GPI use was associated with increased risk of bleeding in both treatment arms. Conclusions Cangrelor’s efficacy in reducing ischemic complications in patients undergoing PCI was maintained irrespective of GPI administration. GPI use was associated with substantially higher bleeding rates, regardless of the randomization to cangrelor or clopidogrel. (A Clinical Trial to Demonstrate the Efficacy of Cangrelor [PCI]: NCT00305162 ; Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition [PLATFORM]: NCT00385138 ; A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention [PCI] [CHAMPION PHOENIX] [CHAMPION]: NCT01156571 )

Published
2017
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12. Cardiopulmonary arrest and extracorporeal membrane oxygenation: Case report and review

Author

Alexander Robinson, Andrew J. Sauer, Travis Abicht, Zubair Shah, Eric Hockstad, and Aniket S Rali

Subjects
medicine.medical_specialty, Resuscitation, medicine.medical_treatment, Case Report, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation, 0302 clinical medicine, Refractory, Internal medicine, Extracorporeal membrane oxygenation, medicine, In patient, critical care cardiology, Cardiac catheterization, business.industry, Advanced cardiac life support, 030208 emergency & critical care medicine, Cardiopulmonary arrest, Oxygenation, extracorporeal membrane oxygenation, medicine.disease, intrahospital arrest, Ventricular fibrillation, Cardiology, business
Abstract

National trends suggest that less than one in four patients experiencing in-hospital cardiac arrest (IHCA) in the United States survive to discharge. This is especially relevant as the rates of IHCA are expected to rise in the years to come. Only a modest upward trend in survival to discharge among patients with IHCA over the past decade warrants evaluation of novel ideas to improve outcomes postcardiopulmonary resuscitation. One such idea is that the use of veno-arterial-extracorporeal membrane oxygenation (VA-ECMO) to augment standard advanced cardiac life support algorithm in patients with an identifiable and reversible cause of cardiac arrest would improve survival to discharge. Here, we present the case of a patient with refractory ventricular fibrillation arrest who was transitioned to VA-ECMO immediately following cardiac catheterization for an IHCA.

Published
2018
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13. Multimodality Imaging in Preparation for Successful Surgical Correction of Giant Right Coronary Artery to Coronary Sinus Fistula

Author

Seyed Hamed Hosseini Dehkordi, Travis Abicht, Thomas Rosamond, Jean-Alfred Thomas, Travis Love, Siva Sagar Taduru, Reza Masoomi, Akshit Sharma, and Eric Hockstad

Subjects
medicine.medical_specialty, business.industry, Fistula, Arteriovenous fistula, Surgical correction, medicine.disease, Surgery, Coronary arteries, medicine.anatomical_structure, Heart failure, Right coronary artery, medicine.artery, medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Coronary sinus
Published
2019
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15. Safety and Feasibility of Rotational Atherectomy in Elderly Patients With Severe Aortic Stenosis

Author

Matthew, Lippmann, Jigar, Patel, Jared, Kvapil, David, Westover, Michael, Pierpoline, Peter, Tadros, Mark, Wiley, George, Zorn, Greg, Muehlebach, Ashwani, Mehta, Eric, Hockstad, Matthew, Earnest, and Kamal, Gupta

Subjects
Aged, 80 and over, Atherectomy, Coronary, Male, Aortic Valve Stenosis, Coronary Artery Disease, Coronary Vessels, Severity of Illness Index, United States, Outcome and Process Assessment, Health Care, Percutaneous Coronary Intervention, Elective Surgical Procedures, Aortic Valve, Monitoring, Intraoperative, Humans, Female, Risk Adjustment, Vascular Calcification, Aged
Abstract

Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD.We retrospectively analyzed the medical records of 29 patients with severe AS who underwent elective RA-facilitated PCI at our center between January 1, 2011 and December 31, 2015.Twenty-nine patients (mean age, 79.8 ± 8.8 years) were enrolled. Mean aortic valve area was 0.71 ± 0.20 cm², mean aortic valve gradient was 40.32 ± 9.88 mm Hg. All PCIs were successful (mean diameter stenosis, 86.3 ± 7.6%; mean burr size, 1.62 ± 0.19 mm). Nineteen patients (65.5%) required temporary pacemaker. Eight patients (27.6%) required vasopressors during PCI. There was a significant reduction in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) during RA, but without clinical events. No procedure was aborted and there were no deaths or clinical myocardial infarctions.RA-facilitated PCI can be safely performed in elderly patients with severe AS and severely calcified CAD with low risk of complications. There was a significant but transient drop in SBP, DBP, MAP, and HR during RA. However, this was not associated with clinically significant adverse events.

Published
2017

16. SYMPTOMATIC ARRHYTHMIAS IN A PATIENT WITH ANOMALOUS ORIGIN OF THE RIGHT CORONARY ARTERY (COMMON PRESENTATION OF AN UNCOMMON DISEASE)

Author

Eric Hockstad, Raghuveer Dendi, Tarun Dalia, Akshit Sharma, and Nilay Patel

Subjects
medicine.medical_specialty, business.industry, Heart block, Disease, medicine.disease, medicine.anatomical_structure, Internal medicine, Right coronary artery, medicine.artery, Anomalous coronary artery, Cardiology, Palpitations, Medicine, Exertion, medicine.symptom, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, business, Sinus (anatomy)
Abstract

Anomalous Coronary Artery arising from Opposite Sinus (ACAOS) is rare anomaly which does not generally lead to heart block & PSVT A 47 years old active, healthy woman presented with dyspnea on exertion & palpitations. On long term cardiac monitor, she had multiple episodes of high-grade AV block

Published
2019
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17. DUAL ANTIPLATELET THERAPY OR ORAL ANTICOAGULATION REDUCES THE INCIDENCE OF ACUTE CORONARY SYNDROMES IN PATIENTS WITH CORONARY ARTERY ECTASIA

Author

Prasad Gunasekaran, Kamal Gupta, Megan Haghnegahdar, Matthew Earnest, John Fritzlen, Buddhadeb Dawn, Peter Tadros, Mark Wiley, Ashwani Mehta, Eric Hockstad, and Taylor Drees

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Incidence (epidemiology), Coronary artery ectasia, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, medicine.disease, Oral anticoagulation
Abstract

The effect of dual antiplatelet therapy (DAPT) or oral anticoagulation on long term incidence of acute coronary syndromes (ACS) in patients with coronary artery ectasia (CAE) and no significant occlusive CAD is not well known. We retrospectively analyzed 317 consecutive cases of CAE. CAE patients

Published
2018
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18. IMPACT OF ACUTE ADMINISTRATION OF CORTICOSTEROIDS PRIOR TO PERCUTANEOUS CORONARY ANGIOGRAPHY IN DIABETIC PATIENTS WITH CONTRAST ALLERGY

Author

Mark Wiley, Eric Hockstad, Ashwani Mehta, Bashar S. Amr, Tarun Dalia, Nilay Patel, Peter Tadros, Nicholas Isom, John Chen, Michael Pierpoline, Patrick Tobbia, Mathew Earnest, Matthew Lippman, Kamal Gupta, and Tyler Buechler

Subjects
Coronary angiography, Contrast allergy, Percutaneous, medicine.diagnostic_test, business.industry, Steroid prophylaxis, Steroid use, Anesthesia, Angiography, Medicine, In patient, Cardiology and Cardiovascular Medicine, business
Abstract

Steroid prophylaxis prior to coronary angiography is routine in patients with contrast allergy (CA). We aimed to assess the impact of steroid use in diabetic patients with CA undergoing elective angiography. We retrospectively analyzed records of diabetics with and without CA who underwent

Published
2018
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19. NATIONAL TRENDS AND OUTCOMES OF PERCUTANEOUS ASD/PFO CLOSURE: A REPORT FROM THE NATIONAL INPATIENT SAMPLE

Author

Kamal Gupta, Peter Tadros, Eric Hockstad, Mark Wiley, Ashwani Mehta, Reza Masoomi, and Matthew Earnest

Subjects
medicine.medical_specialty, Percutaneous, business.industry, General surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Pfo closure, Foramen, medicine, 030212 general & internal medicine, National trends, Closure (psychology), Cardiology and Cardiovascular Medicine, business
Abstract

Though percutaneous closure of atrial septal defect (ASD) or patent foramen (PFO) has been available for several years, it has remained controversial due to lack of strong outcomes data and lack of uniform acceptance by the neurology community. We sought to determine nationwide trends in the use of

Published
2018
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20. CLINICAL PRESENTATION, NATURAL HISTORY AND MANAGEMENT OF CORONARY ARTERY ECTASIA

Author

Peter Tadros, Eric Hockstad, Megan Haghnegahdar, Taylor Drees, Matthew Earnest, Mark Wiley, Dusan Stanojevic, John Fritzlen, Reza Masoomi, Kamal Gupta, Ashwani Mehta, Prasad Gunasekaran, and Matthew B. A. McCullough

Subjects
Natural history, medicine.medical_specialty, business.industry, Internal medicine, Coronary artery ectasia, Cardiology, medicine, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, medicine.disease, business
Abstract

Background: Clinical presentation, natural history of coronary artery ectasia (CAE) and prognostic implications of its anatomic classification of are not well known. Methods: We retrospectively analyzed 376 consecutive cases of CAE and angiographically categorized them using the Markis

Published
2017
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21. SAFETY AND FEASIBILITY OF ROTATIONAL ATHERECTOMY IN ELDERLY PATIENTS WITH SEVERE AORTIC STENOSIS AND CALCIFIC CORONARY ARTERY DISEASE UNDERGOING EVALUATION FOR TRANSCATHETER AORTIC VALVE REPLACEMENT

Author

Eric Hockstad, Matthew Earnest, Matthew Lippmann, Jigar Patel, Michael Pierpoline, Kamal Gupta, Peter Tadros, Ashwani Mehta, Mark Wiley, and Jared Kvapil

Subjects
medicine.medical_specialty, Transcatheter aortic, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Rotational atherectomy, medicine.disease, Orbital atherectomy, Coronary artery disease, Stenosis, Valve replacement, Internal medicine, Conventional PCI, medicine, Cardiology, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business
Abstract

Background: Percutaneous coronary intervention (PCI) followed by transcatheter valve replacement is an alternative for patients with severe aortic stenosis (SAS) and coronary artery disease (CAD). In many, the coronaries are calcific and best treated with rotational or orbital atherectomy (RA or OA

Published
2017
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